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Peripheral iron levels in children with attention-deficit hyperactivity disorder: a systematic review and meta-analysis.
Sci Rep 2018; 8(1):788SR

Abstract

There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies, including iron. We conducted this meta-analysis to examine the association between ADHD and iron levels/iron deficiency (ID). We searched for the databases of the PubMed, ScienceDirect, Cochrane CENTRAL, and ClinicalTrials.gov up to August 9th, 2017. Primary outcomes were differences in peripheral iron levels in children with ADHD versus healthy controls (HCs) and the severity of ADHD symptoms in children with/without ID (Hedges' g) and the pooled adjusted odds ratio (OR) of the association between ADHD and ID. Overall, seventeen articles met the inclusion criteria. Peripheral serum ferritin levels were significantly lower in ADHD children (children with ADHD = 1560, HCs = 4691, Hedges' g = -0.246, p = 0.013), but no significant difference in serum iron or transferrin levels. In addition, the severity of ADHD was significantly higher in the children with ID than those without ID (with ID = 79, without ID = 76, Hedges' g = 0.888, p = 0.002), and there was a significant association between ADHD and ID (OR = 1.636, p = 0.031). Our results suggest that ADHD is associated with lower serum ferritin levels and ID. Future longitudinal studies are required to confirm these associations and to elucidate potential mechanisms.

Authors+Show Affiliations

Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Kaohsiung, Taiwan. WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan.Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Kaohsiung, Taiwan.Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.Prospect clinic for otorhinolaryngology & neurology, Kaohsiung, Taiwan.Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK. Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, UK. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK.ESPA Research, 2A Hylton Park Road, Sunderland, SR5 3HD, UK.Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan. Graduate institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center Taipei, Taipei, Taiwan.Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.Department of Psychiatry, Tainan hospital, Ministry of Health and Welfare, Tainan, Taiwan.Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.Department of pediatrics, DA-AN women and children hospital, Tainan, Taiwan.Department of Child Psychiatry, Chang Gung Memorial Hospital at Taoyuan and Chang Gung University, Taoyuan, Taiwan.Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Kaohsiung, Taiwan.Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. py1029@adm.cgmh.org.tw. Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. py1029@adm.cgmh.org.tw.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

29335588

Citation

Tseng, Ping-Tao, et al. "Peripheral Iron Levels in Children With Attention-deficit Hyperactivity Disorder: a Systematic Review and Meta-analysis." Scientific Reports, vol. 8, no. 1, 2018, p. 788.
Tseng PT, Cheng YS, Yen CF, et al. Peripheral iron levels in children with attention-deficit hyperactivity disorder: a systematic review and meta-analysis. Sci Rep. 2018;8(1):788.
Tseng, P. T., Cheng, Y. S., Yen, C. F., Chen, Y. W., Stubbs, B., Whiteley, P., ... Lin, P. Y. (2018). Peripheral iron levels in children with attention-deficit hyperactivity disorder: a systematic review and meta-analysis. Scientific Reports, 8(1), p. 788. doi:10.1038/s41598-017-19096-x.
Tseng PT, et al. Peripheral Iron Levels in Children With Attention-deficit Hyperactivity Disorder: a Systematic Review and Meta-analysis. Sci Rep. 2018 01 15;8(1):788. PubMed PMID: 29335588.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Peripheral iron levels in children with attention-deficit hyperactivity disorder: a systematic review and meta-analysis. AU - Tseng,Ping-Tao, AU - Cheng,Yu-Shian, AU - Yen,Cheng-Fang, AU - Chen,Yen-Wen, AU - Stubbs,Brendon, AU - Whiteley,Paul, AU - Carvalho,Andre F, AU - Li,Dian-Jeng, AU - Chen,Tien-Yu, AU - Yang,Wei-Cheng, AU - Tang,Chia-Hung, AU - Chu,Che-Sheng, AU - Yang,Wei-Chieh, AU - Liang,Hsin-Yi, AU - Wu,Ching-Kuan, AU - Lin,Pao-Yen, Y1 - 2018/01/15/ PY - 2017/05/30/received PY - 2017/12/16/accepted PY - 2018/1/17/entrez PY - 2018/1/18/pubmed PY - 2018/11/21/medline SP - 788 EP - 788 JF - Scientific reports JO - Sci Rep VL - 8 IS - 1 N2 - There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies, including iron. We conducted this meta-analysis to examine the association between ADHD and iron levels/iron deficiency (ID). We searched for the databases of the PubMed, ScienceDirect, Cochrane CENTRAL, and ClinicalTrials.gov up to August 9th, 2017. Primary outcomes were differences in peripheral iron levels in children with ADHD versus healthy controls (HCs) and the severity of ADHD symptoms in children with/without ID (Hedges' g) and the pooled adjusted odds ratio (OR) of the association between ADHD and ID. Overall, seventeen articles met the inclusion criteria. Peripheral serum ferritin levels were significantly lower in ADHD children (children with ADHD = 1560, HCs = 4691, Hedges' g = -0.246, p = 0.013), but no significant difference in serum iron or transferrin levels. In addition, the severity of ADHD was significantly higher in the children with ID than those without ID (with ID = 79, without ID = 76, Hedges' g = 0.888, p = 0.002), and there was a significant association between ADHD and ID (OR = 1.636, p = 0.031). Our results suggest that ADHD is associated with lower serum ferritin levels and ID. Future longitudinal studies are required to confirm these associations and to elucidate potential mechanisms. SN - 2045-2322 UR - https://www.unboundmedicine.com/medline/citation/29335588/Peripheral_iron_levels_in_children_with_attention_deficit_hyperactivity_disorder:_a_systematic_review_and_meta_analysis_ L2 - http://dx.doi.org/10.1038/s41598-017-19096-x DB - PRIME DP - Unbound Medicine ER -